Adolescent nutrition: what do pediatricians do?

Multiple psychosocial problems and many chronic diseases of adulthood can be influenced by adolescent nutritional problems. In Korea, adolescent obesity and obesity related health risks have been increased and insufficient intakes of nutrients, such as calcium, iron and potassium, and distorted thinking about obesity are also common. However there are no comprehensive countermeasure because of the excessive burden of studies and the lack of community interest. And the nutrition guidelines that is suitable for Korean adolescent leaves something to be desired, and the pediatrician's concern is lacking yet. In the Korean dietary reference intakes 2010 that was revised according to the 2007 Korean National Growth Chart and 2007 Korean National Health and Nutrition Examination Survey, the range for adolescents is changed to the age 12-18 and dietary reference intakes of some nutrients mainly with vitamin D is changed. Recently several researches, about how school nutrition policies and media effect on eating habits and the weight concerns, and influences of public nutrition policies and fast food commercials have been actively studied to improve adolescent nutritive conditions. In this review, I summarize the dietary reference intakes for Korean adolescents that were revised in 2010, and current studies about the adolescent nutrition

Income-Related Health Inequalities in Korea

Data from the 2001 Korean National Health and Nutrition Examination Survey and the ill health concentration index (CI) were used to examine income-related health inequalities among Koreans. Participants (>19 years old) were requested to provide information regarding monthly household income, expenditures, subjective living conditions, and health status. Ill health was determined both subjectively through self-rated health (SRH) scores and objectively through the number of diseases (ND). At the individual level, the CIs for SRH and ND were -0.147 and -0.093, respectively; age–gender adjusted CIs were -0.065 and -0.071, respectively. These values remained unchanged when estimating CI for grouped data. These results indicate that ill health was more pronounced among lower income groups in Korea. However, avoidable health inequality in Korea was smaller than in the United Kingdom and the United States, larger than in Sweden, Eastern Germany, Finland, and Western Germany, and roughly equal to the Netherlands, Spain, and Switzerland

Relationship between Adult Handgrip Strength and Metabolic Syndrome

Background: Metabolic syndrome is becoming more prevalent around the world, with insulin resistance and obesity as particularly critical factors determining the condition. It is known that insulin resistance has a very strong correlation between muscle mass and muscular strength. However, there are few studies on the relationship between handgrip strength and metabolic syndrome, and those studies that have been carried out have mainly focused on the elderly. The purpose of the current study is to use the Korea National Health and Nutrition Examination Survey to identify the relationship between handgrip strength and metabolic syndrome among Korean adults aged 19 years old and above. Participants and methods: The Korea National Health and Nutrition Examination Survey is a nationwide cross-sectional survey that assesses the health and nutritional status of the Korean population. The current study analyzed the relationship between grip strength and metabolic syndrome of 10,094 Korean adults aged ≥19 years (4,402 men and 5,692 women) in the Korea National Health and Nutrition Examination Survey (2014-2017). Those with cancer or those who had experienced a stroke, angina, or myocardial infarction were excluded, as were pregnant or breast-feeding women. The diagnostic criteria for metabolic syndrome were based on those of the American Heart Association/National Heart Long and Blood Institute, which are altered versions of the National Cholesterol Education Program – Adult Treatment Panel III criteria. Grip strength was measured data using a digital grip strength dynamometer. Results: Logistic regression analysis was performed by dividing grip strength into quintiles. A significant decrease in figures compared to Q1 in the odds ratio for both men and women was observed due to age adjustment (Q2: 0.84, Q3: 0.43, Q4: 0.24, Q5: 0.15 for men; Q2: 0.63, Q3: 0.41, Q4: 0.23, Q5: 0.08 for women). Also, due to the correction of demographic factors (age, educational status, marital status, income status, smoking status, drinking status, and menopausal status for women), the odds ratio significantly decreased figures compared to Q1 for both men and women (Q2: 0.80, Q3: 0.37, Q4: 0.21, Q5: 0.13 for men; Q2: 0.63, Q3: 0.45, Q4: 0.24, Q5: 0.09 for women). Conclusions: Higher grip strength brought down the risk of metabolic syndrome for both men and women. Therefore, to prevent and treat metabolic syndrome, it is recommended that patients exercise steadily to enhance muscular strength and muscle mass for better health outcomes. [Ethiop. J. Health Dev. 2020;34(Special issue-3):18-27] Keywords: Muscle strength, metabolic syndrome, grip strength, grip strength/body weigh

Regional disparities in healthy eating and nutritional status in South Korea: Korea National Health and Nutrition Examination Survey 2017

BACKGROUND/OBJECTIVES: Concerns about regional disparities in heathy eating and nutritional status among South Korean adults are increasing. This study aims to identify the magnitude of regional disparities in diet and nutritional status among Korean adults who completed the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: The participants were a nationally representative sample of Korean adults aged 19 years and older from the 2017 KNHANES (n = 6,126). We employed the svy commands in STATA to accommodate the complex survey design. The relative concentration index (RCI), absolute concentration index (ACI) and index of disparity were used to measure regional nutritional inequalities. RESULTS: Overweight and obese adults were more prevalent among the poor than among the rich in urban areas (RCI = -0.041; CONCLUSIONS: This study provides useful information identifying opposite directions in the relative concentration curves between urban and rural areas. Adult overweight/obesity was more prevalent among the poor in urban areas, while adult overweight/obesity was more prevalent among the rich in rural areas. Public health nutrition systems should be implemented to identify nutritional inequalities that should be targeted across regions in South Korea

Prevalence of Dietary Supplement Use in Korean Children and Adolescents: Insights from Korea National Health and Nutrition Examination Survey 2007-2009

The purpose of this study was to estimate the prevalence of dietary supplement (DS) use in Korean children and adolescents and to examine the related factors associated with DS use from the 4th Korea National Health and Nutrition Examination Survey. Total 6,131 participants aged between 2 and 18 yr were included in the analysis. We estimated the prevalence of DS use mainly from the DS questionnaire data of the Nutrition Survey. Reported supplements were classified according to the Health Functional Food Code. We also assessed the relationship between DS use and anthropometry, socioeconomic factors, health behaviors, and chronic diseases. Approximately 34% of Korean children and adolescent was taking DS. Younger age (P = 0.003), higher household income (P < 0.001), presence of chronic diseases (P = 0.05), regular meal consumption (P = 0.002), frequent snack consumption (P = 0.001), and normal body mass index rather than overweight (P = 0.10) or obesity (P = 0.03) were associated with the DS use after adjustment for related factors. Vitamin/mineral supplements (343.5/103 persons) were the most commonly taken DS in Korean children and adolescents, followed by Omega-3 (28.8), ginseng (18.3), colostrums (14.1) and chlorella/spirulina (10.0). In conclusion, DS use is common as much as in 34% of Korean children and adolescents and is associated with age, household income level, chronic diseases, meal regularity, and obesity status

The impact of out of pocket payments on health care inequality: the case of national health insurance in South Korea

The global financial crisis of 2008 has led to the reinforcement of patient cost sharing in health care policy. This study aimed to explore the impact of direct out-of pocket payments (OOPs) on health care utilization and the resulting financial burden across income groups under the South Korean National Health Insurance (NHI) program with universal population coverage. We used the fourth Korean National Health and Nutrition Examination Survey (KNHNES-IV) and the Korean Household Income and Expenditure Survey (KHIES) of 2007, 2008 and 2009. The Horizontal Inequity Index (HIwv) and the average unit OOPs were used to measure income-related inequity in the quantitative and qualitative aspects of health care utilization, respectively. For financial burden, the incidence rates of catastrophic health expenditure (CHE) were compared across income groups. For outpatient and hospital visits, there was neither pro-poor or pro-rich inequality. The average unit OOPs of the poorest quintile was approximately 75% and 60% of each counterpart in the richest quintile in the outpatient and inpatient services. For the CHE threshold of 40%, the incidence rates were 5.7%, 1.67%, 0.72%, 0.33% and 0.27% in quintiles I (the poorest quintile), II, III, IV and V, respectively. Substantial OOPs under the NHI are disadvantageous, particularly for the lowest income group in terms of health care quality and financial burden

Risk factors of type 2 diabetes among Korean adults: The 2001 Korean national health and nutrition examination survey

This study aimed to identify risk factors for type 2 diabetes (T2D) in Korea, a rapidly changing country. Data of 5,132 adults aged 20-85 were used from the 2001 Korean Health and Nutrition Examination Survey. Multiple logistic regression was carried out to identify risk factors for T2D. Three models were specified: (i) socioeconomic and demographic factors (model 1: age, gender, education, poverty income ratio, employment), (ii) behavioral risk factors and covariates (model 2: obesity, physical activity, smoking, alcohol drinking, dietary quality, family history of T2D, co-morbidity) and (iii) socioeconomic, demographic, and behavioral factors (model 3). The prevalence of T2D was 7.4%. Less education (OR 1.41, 95% CI 1.08-1.84), age (OR 2.19, 95% CI 1.56-3.08 in 40-59 yrs, OR 4.05, 95% CI 2.76-5.95 in 60 yrs + comparing to 20-39 yrs) and abdominal obesity (OR 2.24, 95% CI 1.79-2.82) were risk factors for T2D even after controlling for other factors simultaneously. There was a significant association of T2D with ever smoking (OR 1.34, 95% CI 1.06-1.67). The relationship of age with T2D was modified by gender in model 1 and the relationship of smoking with T2D was modified by obesity in model 2. Less educated, older, obese or ever smokers were more likely to have T2D. Gender mediated the relationship of age, and obesity mediated the relationship of smoking, with T2D. Intervention programs for T2D in Korea should take the interactions among risk factors into account

Depressive mood and children: Europe and South Korea

Using data for the third wave from the European Social Survey (ESS) and the Fourth Korean National Health and Nutrition Examination Survey (K-NHANES), this research examines the relationship between having children at home and depression among men and women aged 18-75 years. Multilevel and probit regression models are applied. Our results show that there is a gender differential in depression. Having children at home improves psychological well-being for men only in 23 European countries and South Korea. In Europe we also find that depression tends to be lower in countries in which per capita income is higher. The results also show that household income is negatively associated with levels of depression in South Korea

Prevalence and Risk Factors for Refractive Errors: Korean National Health and Nutrition Examination Survey 2008-2011

PURPOSE To examine the prevalence and risk factors of refractive errors in a representative Korean population aged 20 years old or older. METHODS A total of 23,392 people aged 20+ years were selected for the Korean National Health and Nutrition Survey 2008-2011, using stratified, multistage, clustered sampling. Refractive error was measured by autorefraction without cycloplegia, and interviews were performed regarding associated risk factors including gender, age, height, education level, parent's education level, economic status, light exposure time, and current smoking history. RESULTS Of 23,392 participants, refractive errors were examined in 22,562 persons, including 21,356 subjects with phakic eyes. The overall prevalences of myopia ( 0.5 D) were 48.1% (95% confidence interval [CI], 47.4-48.8), 4.0% (CI, 3.7-4.3), and 24.2% (CI, 23.6-24.8), respectively. The prevalence of myopia sharply decreased from 78.9% (CI, 77.4-80.4) in 20-29 year olds to 16.1% (CI, 14.9-17.3) in 60-69 year olds. In multivariable logistic regression analyses restricted to subjects aged 40+ years, myopia was associated with younger age (odds ratio [OR], 0.94; 95% Confidence Interval [CI], 0.93-0.94, p < 0.001), education level of university or higher (OR, 2.31; CI, 1.97-2.71, p < 0.001), and shorter sunlight exposure time (OR, 0.84; CI, 0.76-0.93, p = 0.002). CONCLUSIONS This study provides the first representative population-based data on refractive error for Korean adults. The prevalence of myopia in Korean adults in 40+ years (34.7%) was comparable to that in other Asian countries. These results show that the younger generations in Korea are much more myopic than previous generations, and that important factors associated with this increase are increased education levels and reduced sunlight exposures

Effect of diabetes index on periodontal disease in Korean adults

Background: It is known that diabetes can cause complications in various organs and affect oral health. The purpose of this study was to investigate the relationship between oral health and diabetes mellitus among Korean adults. Materials and methods: The study was conducted by the National Institute of Health and Nutrition Examination Survey (2015), produced by the Korea Centers for Disease Prevention and Control. A total of 4,780 patients took part in the survey of which 554 were diabetic patients. Descriptive statistics were used to identify the periodontal disease status of non-diabetics and people with diabetes mellitus, and multiple regression analysis was performed to analyze the effect of diabetes index on periodontal disease status. Results: Normal people showed better periodontal disease and oral care status than diabetic patients. However, all three diabetic factors (glycated hemoglobin, fasting blood sugar, insulin) had no statistically significant influence on periodontal disease. Conclusions: The increase in the diabetic index may have a negative effect on various periodontal diseases, which may ultimately lead to poor oral hygiene and cause disease. Therefore, diverse studies on the diabetic index and periodontal disease are needed, and it is necessary to address the dental hygiene health of Korean adults through early education and campaigns to improve oral health. [Ethiop.J. Health Dev. 2020;34(Special issue-3):78-83] Keywords: Diabetes index, periodontal disease, oral health, Korean adult